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Silent Myocardial Infarction and Acute Multiorgan Failure in a COVID-19 Patient: A Case Report

Nischit Baral1, Andrea Montalbano2, Ashiya Khan1

  • 1Department of Internal Medicine, Mclaren Flint/Michigan State University College of Human Medicine, United States of America.

JNMA; Journal of the Nepal Medical Association
|February 24, 2022
PubMed

Insights

Silent myocardial infarction (SMI) is more common in older adults. This case report highlights SMI in a COVID-19 patient, emphasizing the need for cardiac evaluation in all COVID-19 cases, especially the elderly.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Geriatrics

Background:

  • Silent myocardial infarction (SMI) is increasingly recognized in elderly individuals with cardiovascular risk factors.
  • The prevalence of SMI in patients with COVID-19 remains largely unknown.
  • COVID-19 is associated with cardiovascular complications, but silent presentations are not well-documented.

Observation:

  • A 77-year-old male with COVID-19 pneumonia presented with diabetic ketoacidosis and multiorgan failure.
  • The patient experienced a silent ST-segment elevation myocardial infarction (STEMI) without typical anginal symptoms.
  • This represents the first reported case of SMI in a COVID-19 patient.

Findings:

  • Cardiac catheterization revealed ostial right coronary artery stenosis.
  • A drug-eluting stent was successfully placed following a specialized safety protocol.
  • The patient was discharged in stable condition to an extended-care facility.

Implications:

  • COVID-19 patients, particularly the elderly, require cardiac evaluation for acute myocardial infarction, even in the absence of symptoms.
  • Prompt diagnosis and intervention for myocardial infarction in COVID-19 patients, using appropriate safety measures, can be life-saving.
  • This case underscores the importance of considering silent myocardial infarction in the differential diagnosis of COVID-19 presentations.

Keywords:
case reports; COVID-19; myocardial infraction; ST elevation myocardial infarction.

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